Heart Implants

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HEART IMPLANTS

HEART IMPLANTS. Because of the high rate of congestive heart failure, physicians in the United States sought to solve the problem through cardiac transplants. In 1964, James Hardy attempted the first such operation, inserting a chimpanzee's heart into a terminally ill patient who died three hours after the surgery. After Christiaan Barnard of South Africa made the first successful human cardiac transplant in 1967, university hospitals in the United States began using Barnard's method. Among the most successful were Norman Shumway and his team at Stanford University—they developed a combined heart and lung transplant in 1980. Meanwhile, Denton Cooley, in 1969, implanted the first completely artificial heart in a human, and in the early 1980s, Willem Kolff and Robert Jarvik produced artificial hearts to keep patients alive until donor hearts became available.

By the late 1980s, cardiac implants had become the established treatment for terminal heart disease. With immunosuppression therapies and the curtailment of infectious diseases, cardiologists overcame most implant rejections and greatly prolonged survival rates of transplant patients—80–90 percent after one year, and 70–80 percent after five years by the early 1990s. A Kentucky man successfully received the first fully self-contained artificial heart on 3 July 2001, marking a new era in heart implantation.

Medical ethicists have raised questions about priority lists for receiving heart transplants. Some physicians believe in assigning priority to primary transplant candidates because repeat transplant patients have poorer survival chances than first-time candidates. While 2,299 patients received heart transplants in 1993 in the United States, more than 3,000 remained on the waiting list at the end of that year.

BIBLIOGRAPHY

Fye, Bruce W. American Contributions to Cardiovascular Medicine and Surgery. Bethesda, Md.: National Library of Medicine, 1986.

Ubel, Peter A., et al. "Rationing Failure: The Ethical Lessons of the Retransplantation of Scarce Vital Organs," Journal of the American Medical Association 270, no. 20 (November 1993): 2469–2474.

Ruth RoyHarris/c. w.